Editorials - 24-05-2021

Protecting total expenditures at the budgeted level and mass vaccination are important in India’s pandemic situation

The second wave of COVID-19 currently sweeping India is forcing States into successive lockdowns, in turn eroding economic activities. The growth projections of different national and international agencies and the fiscal projections of Centre’s 2021-22 Budget require recalibration.

COVID-19-induced erosion

The International Monetary Fund (IMF), the Reserve Bank of India (RBI), and the Ministry of Finance’s Economic Survey had forecast real GDP growth for 2021-22 at 12.5%, 10.5%, and 11.0%, respectively. Moody’s has recently projected India’s GDP growth in 2021-22 at 9.3% (https://bit.ly/3fIkWs8). This is close to the benchmark growth rate of 8.7% which would keep India’s GDP at 2011-12 prices at the same level as in 2019-20. This level of growth may be achieved based on the assumption that the economy normalises in the second half of the fiscal year. If the lockdowns come to an end earlier, the growth rate may be higher, but that is perhaps unlikely.

The 2019-20 real GDP was Rs. 145.7-lakh crore at 2011-12 prices. It fell to Rs. 134.1-lakh crore in 2020-21, implying a contraction of minus 8.0%. If even the growth rate of 8.7% for 2021-22 comes under challenge because of a prolonged lockdown, not only will India see a fall in the real GDP in the current year as compared to 2019-20 level but the nominal GDP numbers assumed in the Budget will also be belied adversely affecting the fiscal aggregates in the Centre’s 2021-22 Budget. At 8.7% real growth, the nominal GDP growth would be close to 13.5%, assuming an inflation rate of 4.5%. This would be lower than the nominal growth of 14.4% assumed in the Union Budget. At 13.5% growth, the estimated GDP for 2021-22 is Rs. 222.4-lakh crore at current prices. This will lead to a lowering of tax and non-tax revenues and an increase in the fiscal deficit as compared to the budgeted magnitudes.

Budget magnitudes

The budgeted gross and net tax revenues for 2021-22 were Rs. 22.2-lakh crore and Rs. 15.4-lakh crore, respectively. The assumed buoyancy for the Centre’s gross tax revenues (GTR) was 1.2. Even if this buoyancy is achieved, the lower nominal GDP growth would imply a GTR growth of 15.7% as compared to the budgeted growth of 16.7%. If, however, the buoyancy of 1.2 proves optimistic and instead a buoyancy of 0.9, which is the average buoyancy of the five years preceding the COVID-19 year, is applied, the nominal growth of GTR would be 12.2%. This would lead to the Centre’s GTR of about Rs. 21.3-lakh crore. The corresponding shortfall in the Centre’s net tax revenues is estimated to be about Rs. 0.6 lakh crore.

The budgeted magnitudes for non-tax revenues and non-debt capital receipts at Rs. 2.4-lakh crore and Rs. 1.9-lakh crore, respectively, may also prove to be optimistic. In these cases, the budgeted growth rates were 15.4% and 304.3%, respectively. The excessively high growth for the non-debt capital receipts was premised on implementing an ambitious asset monetisation and disinvestment programme. The COVID-19-disturbed year may not permit any of this. The budgeted growth in non-tax revenues is largely dependent on an assumed growth of 60% in revenues from communication services and of 44.1% in dividends and profits from non-departmental undertakings. We consider that a shortfall of Rs. 1.5-lakh crore in non-tax revenues and non-debt capital receipts together may not be ruled out. Together with the tax revenue shortfall of nearly 0.6 lakh crore, the total shortfall on the receipts side may be about Rs. 2.1-lakh crore.

Two factors will affect the fiscal deficit estimate of 6.76% of GDP in 2021-22. First, there would be a change in the budgeted nominal GDP growth. Second, there would be a shortfall in the receipts from tax, non-tax and non-debt sources. The budgeted magnitude of fiscal deficit is Rs. 15.06-lakh crore. Together, these two factors may lead to a slippage in fiscal deficit which may be close to 7.7% of GDP in 2021-22 if total expenditures are kept at the budgeted levels. This would call for revising the fiscal road map again. Protecting total expenditures at the budgeted level is, however, important given the need to support the economy in these challenging times. There is a case for reprioritising these expenditures.

Other steps, vaccination

The second wave of the novel coronavirus has put a spotlight on India’s serious under-capacity in health infrastructure. Given the likelihood of a third COVID-19 wave, there is an urgent need to ramp up health and related infrastructure by enhancing the number of hospitals and hospital beds, sources of oxygen supplies, and the manufacture of COVID-19 vaccines and drugs. The Centre’s 2021-22 Budget has provided for Rs. 71,269 crore for the Department of Health and Family Welfare. This included a budgeted capital expenditure of Rs. 2,508.7 crore. In contrast, in 2020-21, the total health and family welfare expenditure (RE) was Rs. 78,866 crore, implying a fall of Rs. 7,597 crore in 2021-22. In the budgeted capital expenditure for health also, there was a fall of Rs. 1,724.8 crore as compared to the RE of 2020-21 at Rs. 4,233.5 crore. Clearly, these magnitudes are quite inadequate for an economy challenged by COVID-19 for two successive years. The allocation for the health sector should be increased substantially by reprioritising expenditures.

Construction activities within the health sector will have high multipliers. There may also be higher expenditure on inducting a larger workforce of doctors, nurses and paramedics and other hospital-related administrative staff. Furthermore, strong support is needed for the vulnerable groups of the society including migrant labour and the rural and urban unemployed population.

Speedy and larger vaccination coverage of the vulnerable population is key to minimising economic damage.

The Centre’s Budget had allocated Rs. 35,000 crore for vaccination as shown in the Budget for the Department of Finance (demand for grant number 40) as an amount to be transferred to the States. India’s population aged 12 years and above is 109 crore. Total vaccination doses (at two doses per person) adds to 218 crore. At an average price of Rs. 300 per dose, this would require an amount of Rs. 65,108 crore. This is a rough estimate.

The cost to the government would be less if the coverage is less than full. COVID-19 vaccination is characterised by strong inter-State positive externalities, making it primarily the responsibility of the central government. The entire vaccination bill should be borne by the central government. Rather than having individual State governments floating global tenders for vaccines, if the central government is the single agency for vaccine procurement, the economies of scale and the Centre’s bargaining power would keep the average vaccine price low. The total vaccination cost would go up if the unit cost goes up. The central government may transfer the vaccines rather than the money that it has budgeted for transfer. Some of the smaller States may find procuring vaccines through a global tender to be quite challenging.

C. Rangarajan is former Chairman, Economic Advisory Council to the Prime Minister and a former Governor, Reserve Bank of India. D.K. Srivastava is Chief Policy Advisor, EY India and a former Director, Madras School of Economics. The views expressed are personal

Environmental fiscal reforms will reduce pollution and generate resources for financing the health sector

The Indian government announced a pandemic-related stimulus package in FY 2020-21 though there was large decline in tax revenue. The fiscal deficit for FY 2020-21 (revised estimates) is projected to be 9.5% of the GDP; for 2021-22, it is pegged at 6.8%. The focus is on maintaining fiscal discipline. In this peculiar scenario, sustained health financing in India remains a challenge.

Household spending on health

The World Health Organization (WHO) provides data on the percentage of the total population where the household expenditure on health was greater than 10% and 25% of the total household expenditure or income in India in 2011. This provides a clear picture of the status of spending on health by the rural and urban populations. As far as health expenditure above 10% is concerned, 17.33% of the population in India made out-of-pocket payments on health. The percentage was higher in rural areas compared to urban areas. Globally, the average was 12.67%, which means that 12.67% of the population spent more than 10% of their income (out of their pocket) on health. In Southeast Asia, 16% spent more than 10% of their household income on health. The Western Pacific region came second in the list of regions that saw a rate higher than the global average. Similarly, 3.9% of the population in India made more than 25% of out-of-pocket payments on health, with 4.34% in the rural areas.

The Economic Survey of India 2019-20 has outlined the fact that an increase in public spending from 1% to 2.5-3% of GDP, as envisaged in the National Health Policy of 2017, can decrease out-of-pocket expenditure from 65% to 30% of overall healthcare expenses. This is where the importance of alternate sources of health financing in India needs to be stressed. The COVID-19 pandemic has also forced countries all over the world to rethink climate change and the need for preservation of the environment. Fiscal reforms for managing the environment are important, and India has great potential for revenue generation in this aspect.

Fixing the eco rax rate

Environment regulation, in turn, may take several forms: command and control; economic planning/urban planning; environmental tax (eco tax)/subsidies; and cap and trade. India currently focuses majorly on the command-and-control approach in tackling pollution. The success of an eco tax in India would depend on its architecture, that is, how well it is planned and designed. It should be credible, transparent and predictable. Ideally, the eco tax rate ought to be equal to the marginal social cost arising from the negative externalities associated with the production, consumption or disposal of goods and services. This requires an evaluation of the damage to the environment based on scientific assessments. This would include the adverse impacts on the health of people, climate change, etc. The eco tax rate may, thus, be fixed commensurate to the marginal social cost so evaluated. The Madras School of Economics had already undertaken extensive studies in this regard.

Environmental tax reforms generally involve three complementary activities: (a) eliminating existing subsidies and taxes that have a harmful impact on the environment; (b) restructuring existing taxes in an environmentally supportive manner; and (c) initiating new environmental taxes. Taxes can be designed either as revenue neutral or revenue augmenting. In case of revenue augmenting, the additional revenue can either be targeted towards the provision of environmental public goods or directed towards the overall revenue pool. In developing countries like India, the revenue can be used to a greater extent for the provision of environmental public goods and addressing environmental health issues.

In India, eco taxes can target three main areas: one, differential taxation on vehicles in the transport sector purely oriented towards fuel efficiency and GPS-based congestion charges; two, in the energy sector by taxing fuels which feed into energy generation; and three, waste generation and use of natural resources. Tax revenues can be generated through eco taxes. There is also a need to integrate environmental taxes in the Goods and Service Tax framework as highlighted by the Madras School of Economics in its studies.

Negligible impact on the GDP

The implementation of an environmental tax in India will have three broad benefits: fiscal, environmental and poverty reduction. Environmental tax reforms can mobilise revenues to finance basic public services when raising revenue through other sources proves to be difficult or burdensome. Revenue from environmental tax reforms can also be used to reduce other distorting taxes such as fiscal dividend. Environmental tax reforms help internalise the externalities, and the said revenue can finance research and the development of new technologies.

Environmental regulations may have significant costs on the private sector in the form of slow productivity growth and high cost of compliance, resulting in the possible increase in the prices of goods and services. However, the European experience shows that most of the taxes also generate substantial revenue and there is no evidence on green taxes with sustainable development goals leading to a ‘no growth’ economy. Most countries’ experiences suggest negligible impact on the GDP, though such revenues have not necessarily been used for environmental considerations. Thus, the negligible impact on the GDP may be a temporary phenomenon.

Hence, this is the right time for India to adopt environmental fiscal reforms as they will reduce environmental pollution and also generate resources for financing the health sector.

Eduardo Araral is Associate Professor at the Lee Kuan Yew School of Public Policy and Surjith Karthikeyan is an Indian Economic Service officer. Views are personal

An independent vigilance system and an administrative machinery capable of affirmative outputs are solutions

In the gloomy battle against the novel coronavirus pandemic, what has emerged as most reprehensible is the brazen attempt by profiteers in filling the gap following the desperation of many patients and families. With the second wave of infections and the rise in COVID-19 positive cases in India, the necessity for integral medicines, hospital beds and oxygen supplies has gone up incrementally. For example, we come across information about government helpline numbers being circulated widely. The Twitter handles of politicians and administrative executives often reiterate the dependability of these helplines. These helpline numbers ought to be not just ‘ray of hope’ delivery systems but also a clear demarcation between what is legal and officially authorised, and what is not.

Flourishing market

Remdesivir and tocilizumab have been the most sought after drugs ever since the pandemic set in. In July 2020 a racket of selling fake and spurious tocilizumab injections in Surat and Ahmedabad was unearthed by the Gujarat Food and Drugs Control Administration. Almost a year later, things do not seem to have improved. Recently, the police in Ahmedabad arrested a few people for preparing fake remdesivir vials for sale using a mixture of glucose and salt and affixing them with fake brand labels. In Mumbai’s drug black market, citizens have had to pay huge amounts ranging from Rs. 35,000 and Rs. 50,000 for remdesivir vials. In Kanpur, Uttar Pradesh, a racket to market oxygen cylinders in the black market was uncovered after raids on a godown. The Haryana police have registered at least 21 FIRs in connection with the blackmarketing of many of these medical essentials.

The desperate need for vital medical supplies has forced many hapless citizens to pay more than the market price to procure these medicines. There are reports of many having been tricked into believing fire extinguishers to be oxygen cylinders and saline water bottles to be remdesivir vials after parting with huge sums of money. However, clamping down on these cases and the culprits is dependent on having an efficient multi-dimensional preventive model rather than a control mechanism that functions much after the damage has been already done.

India is in the middle of its second year in the battle against the COVID-19 virus and the persistent challenges many citizens face in medical aid is a wake-up call to revisit the administrative mechanism and map its limitations. In India, the distribution of remdesivir in the States is mostly controlled by the local governments,while decisions about oxygen supplies to the States are predominantly decided by Union bodies. Yet, citizens have been approaching alien sources to procure medical supplies.

The pressures

A major reason behind why many are in the situation they are facing is because administrative organisations are being overwhelmed and helpline numbers inundated with calls and difficult to connect to. Even if citizens are fortunate enough to have their requests entered in records, they may not be able to procure the products they need due to the inadequacy of resources or probably not receiving a closure communication from helplines, which keeps them at a loose end without knowing where else to go and what else to do. This inaccessibility, a redundant and long communication process flow, and a delay in rendering responses are what have affected the reliability of these helplines as far as people are concerned.

Any market, black or otherwise, is a dynamic hemisphere which is consumer-driven. There is public demand for what the products these black markets or rackets have to offer and which is why they thrive. A patient and their attendants face challenges of resource availability and significant constraints of time within which they need a solution, resulting in tremendous mental pressures. Alleged hospital bed-booking scams, the unnecessary hoarding of COVID-19 essentials by the elite, and possible VIP culture practices have contributed to the erosion of trust. These elements have all combined to force the public to look elsewhere for sources beyond the probability of the government rendering them assistance.

Volunteers as a resource

Therefore, administrative mechanisms need to be expanded qualitatively and quantitatively. India is blessed with numerous volunteer organisations trying to tackle the various challenges of the pandemic. Unfortunately, in many instances, they do not enjoy governmental support. The state machinery needs to identify such groups, train them, optimise them and deploy them on a priority basis and ensure that there is no concentration of human resources in a single vertical. We need to operationalise technological knowledge in order to ease the communication processes which could reduce the burden on data entry operators and the management information systems to induce better responsive behaviour. We need an expert planning model which not only allocates the resources judiciously but also allows a follow-up of the entire process flow to ensure that there are no illegal deviations. In oversight, we need a strong, decentralised and independent vigilance system which promotes transparency in this desperate situation to ensure quality in the performance of administrative set-ups.

At the end of the day, what has been listed above ought to be matched with confidence-building mechanisms. It is only when the government’s performance is high and the administrative machinery is capable of large-scale affirmative outputs that the public will not have to look for third party resources. And with no dependency subsisting on them, profiteering would not have a dimension and play its game.

Jayesh Ranjan is in the Indian Administrative Service and works for the Government of Telangana. Amulya Anil is a law student at Symbiosis Law School, Hyderabad. The views expressed are personal

Journalism provides the space to articulate diverse ideas and this space cannot be surrendered to bad faith campaigns

In less than three weeks since she started her journalistic career at The Associated Press (AP), Emily Wilder, a graduate of Stanford University, was fired for her social media posts on the Israel-Palestine conflict. The AP took this drastic decision following a campaign by conservatives against her for her activism as a student. Ms. Wilder, who is Jewish, was an active member of the pro-Palestinian groups ‘Jewish Voice for Peace’ and ‘Students for Justice in Palestine’ at Stanford University.The Guardianrevealed that she was “terminated for violating the company’s social media policies” during her brief stint. She wrote a tweet about objectivity, which read: “‘Objectivity’ feels fickle when the basic terms we use to report news implicitly stake a claim. Using ‘Israel’ but never ‘Palestine’, or ‘war’ but not ‘siege and occupation’ are political choices — yet [the] media makes those exact choices all the time without being flagged as biased.”

Social media policies of newsrooms

This raises many questions about the professional space for journalists, where one has to negotiate many contending and often conflicting interests. Where does one’s right as a citizen end? Can institutions veto someone’s considered positions? I have been arguing for long that journalists should express themselves in their journalism rather than in their social media posts. The reservations about the social media policies of news organisations are not over the sections that deal with professional conduct but over the sections that fail to grant space for ethical choices concerning major developments, whether the Israel-Palestine issue or the mismanagement of the pandemic in India.

Interest groups often stigmatise journalists for their viewpoints through organised bad faith campaigns. Emily Bell, Director of the Tow Center for Digital Journalism at Columbia Journalism School, feels that newsrooms are clueless in confronting this malaise. She tweeted: “If news organisations cave in to pressure from bad faith campaigns, if they cancel workplace contracts on the basis of student activism or errors of judgment, then the field will miss out on some great reporters. Newsrooms are too often unprepared for this predictable onslaught.”

Diversity in the newsroom

Every media scholar acknowledges that a diverse newsroom serves the community well. The American Press Institute (API) has argued that diversity is both a business imperative and a journalistic imperative. On it being a journalistic imperative, the API said: “Without accounting for the range of lived experiences, we fail to serve parts of our communities. Journalism, in its truest form, should be produced for the benefit of all, not only those who wield a particular power, class or authority.” It is important to note that diversity is not restricted to known categories such as race, gender, caste and class. It also includes a range of viewpoints. People who advocate peace and justice instead of the cold geopolitical calculations of strategic establishments create space for humanity. At a time when the deep state spreads its octopus-like tentacles and glosses over human suffering, people who believe in peace dividends are central to the public good.

Let’s remember that young men and women come to journalism because they are idealistic and despite many limitations: they earn less money in journalism than they would in the corporate world and wield less power than they would in bureaucracy or diplomacy. The fact that there is space to articulate diverse ideas is what acts as a magnet for them. This space cannot be surrendered to the relentless bad faith campaigns orchestrated by powerful vested interests.

I have often been asked about the relationship between objective journalism and the personal political views of individual journalists. If journalists do not stray from journalistic principles, especially the act of verification, their personal viewpoints as citizens are not in conflict with the public good. I have often cited the example of one of the most respected political journalists, Walter Lippmann. The journalism programme at Harvard University is housed in a building called Lippmann House. Lippmann is known not only for his outstanding journalism but also for his role in advising President Woodrow Wilson on defining developments such as the creation of the League of Nations and granting voting rights to women.

In order to preserve their independence and vibrancy, newsrooms need to take motivated campaigns to task.


The claim that the new privacy policy is applicable to only the business version of the app is not comforting

The learned senior advocates Kapil Sibal and Arvind Datar submitted to the Delhi High Court that WhatsApp’s contentious new privacy policy came into effect from May 15, 2021. Mr. Sibal raised the central question of national importance, “The question is, does India have a public policy for privacy? If a public policy of privacy is there in India, does it apply to WhatsApp policy?” This question acquires relevance due to the dominant market status of WhatsApp-Facebook-Instagram. In its affidavit to the Delhi High Court, WhatsApp defended its privacy policy and explicitly named Google, Microsoft, Zoom, Zomato, Republic World, Ola Cabs, Truecaller, Big Basket, Koo, and public companies such as Aarogya Setu, Bhim, Air India, Sandes, Government e-Marketplace, and the Indian Railway Catering and Tourism Corporation of having similar policies, of relying on collecting user data.

Advantages of WhatsApp

In the submission, WhatsApp suggested that users who did not agree to its terms and conditions could discontinue use of its service. Apps such as Signal and Telegram provide alternate reliable communication services. While this is a reasonable option for urban users of messaging apps, researchers working with rural and disenfranchised sections have pointed out the reliance on WhatsApp’s services due to the design of the app. WhatsApp has an inherent advantage with its messaging and audio-video calling even in low-bandwidth Internet areas. This has to be seen in conjunction with WhatsApp Pay which allows users to transfer money to others. Thus, a mass migration to more privacy-respecting services appears near-impossible due to vendor lock-in. The observation of the Competition Commission of India that WhatsApp is misusing its dominant status appears relevant here.

The claim that the new privacy policy is applicable to only the business version of the app is not comforting. This is because metadata from the non-business versions are already being exchanged with other services of the Facebook company. Profiling of individual users has already been well documented with the exposure of the Facebook-Cambridge Analytica scandal both internationally and in India. For businesses using WhatsApp, there would be a reasonable expectation that the services would be more secure than the normal version. Thus, diluting the privacy policy for the business version appears counterintuitive. Looking at the practices of large monopoly businesses wherein smaller companies are bought out or innovative services are copied in order to increase the customer base provides an answer. Thus, one would have to surmise that it is possible to extract metadata from documents that are exchanged over a communication app with a diluted privacy policy. The lessons learned from theUnited States v. Microsoft Corporationantitrust case from early 2000 would appear relevant in this context.

Data protection

We would have to understand that a WhatsApp exception, as suggested by Mr. Sibal, would only open the floodgates to further privacy violations by both the state and private entities dealing with user data. There is the issue of potential violation of privacy of children through Ed-Tech apps due to the lack of both a comprehensive ethics policy and a data privacy law akin to the European General Data Protection Regulation (GDPR). In the context of services provided by the above-mentioned companies, the Personal Data Protection Bill of 2019 does not even attempt to provide a fig leaf of protection to users of services.

To ensure that the privacy of the Indian citizen is protected in the digital sphere, the data protection Bill needs to be reformulated to ensure that it focuses on user rights with an emphasis on user privacy. A privacy commission would have to be established to enforce these rights. The government would also have to respect the privacy of the citizens while strengthening the right to information. There is an overarching need for a strong data protection Bill.

Vikram Vincent holds a PhD from IIT Bombay

Entrepreneurs signing guarantee will have to be certain that the business will not flounder

The Supreme Court judgment upholding creditors’ right to proceed against personal guarantors to loans provided by them to a corporate borrower helps lift the uncertainty over the extent to which banks and other financial lenders can pursue not only the corporate debtor but also the individuals who had furnished personal guarantees to enable the flow of credit to the company they had stood surety for. This ought to be of significant consequence to the financial system, already under a mountain of bad loans, by helping expedite the resolution of such stressed assets. The two-judge Bench was considering a clutch of petitions challenging the government’s 2019 notification that made personal guarantors a separate category of individuals who could be proceeded against under the Insolvency and Bankruptcy Code as part of the insolvency proceedings initiated by lenders against defaulting corporate entities. In dismissing the petitions, the judges made clear that the government was right in “carving out personal guarantors as a separate species of individuals”, given the “intimate connection between such individuals and corporate entities to whom they stood guarantee”. Banks now stand a real chance of recovering substantially more from the resolution of a stressed corporate entity, as in most cases it has been the relatively affluent promoters who have been standing as individual personal guarantors for the loans extended to the companies they promoted.

Several corporate leaders are set to be impacted. The promoters of many defaulting corporates, which are facing action under the IBC, had furnished guarantees for thousands of crores in loans availed by the companies they ran. The State Bank of India alone had submitted in the apex court that it had served demand notices aggregating to more than Rs. 39,000 crore to individuals who had signed as guarantors for credit provided to corporate entities. The judges also cleared the air over another issue that is bound to strengthen the creditors’ positions in all ongoing, future and even completed insolvency proceedings. The Bench ruled that the approval of a resolution plan for the corporate debtor does not extinguish the personal guarantor’s liability, which it said “arises out of an independent contract”. Lenders can now proceed against the guarantors to enhance recovery given that most banks agree to ‘haircuts’ when negotiating a resolution plan with a new promoter for the defaulting company. The only wrinkle here is that once the resolution plan becomes legally binding, the guarantor loses the recourse to remedy from the borrower when the creditor invokes the personal guarantee. Entrepreneurs will now have to think twice before signing a personal guarantee unless they can be very certain that the business they found will not flounder.

The rise in mucormycosis cases underlines the need for diabetics to get vaccination

The second wave of the pandemic has thrown up another serious challenge. Besides, in just about three months, the number of daily cases touching 4.14 lakh on May 6 and cumulative cases crossing 15 million, mortality reaching an all-time peak of 4,529 on May 18 and the total number of deaths reaching nearly 1.5 lakh, there is now a growing number of mucormycosis cases being reported in COVID-19 patients. A concerned Health Ministry has now asked all States to classify mucormycosis, a fungal infection, as a notifiable disease under the Epidemic Diseases Act 1897; a few States have complied. As a notifiable disease, every suspected and confirmed case is to be reported to the State Health Department. While the infection is caused by a group of moulds called mucormycetes, which are commonly found in the environment, the fungi are largely harmless under normal circumstances. But COVID-19 patients with uncontrolled diabetes who are on steroid therapy face a higher infection risk. Breathing in the fungi spores can cause an infection in the lungs or sinuses which can spread. Even when blood sugar is under control, indiscriminate steroid use can cause an increase in blood sugar levels, making such patients more susceptible to mucormycosis infection.

Patients with severe COVID-19 disease tend to develop a systemic inflammatory response leading to lung injury and multisystem organ dysfunction. While WHO “strongly recommends” that corticosteroids such as dexamethasone be used in treating patients with severe and critical COVID-19, they should not be used in non-severe COVID-19 patients. The absence of any new or repurposed drugs to effectively treat COVID-19 patients and the lack of clear guidelines in using certain drugs have led to indiscriminate drug use, including steroids. The rise in mucormycosis infection cases should be a wake-up call for COVID-19 patients and medical practitioners to use steroids judiciously for a limited period and in the right dosage, especially in diabetic patients; self-medication with steroids should be avoided at any cost. Most importantly, in COVID-19 patients with diabetes, controlling blood sugar levels using insulin can help prevent mucormycosis infection. While the availability of Amphotericin-B to treat mucormycosis was limited till recently, five manufacturers in India are in the process of ramping up production. Five more companies have also been licensed to augment supplies. Since the infection presents itself with typical symptoms, timely diagnosis is easy. The infection can be cured without even surgery if detected early. This is one more reason why people, particularly those with diabetes, should get vaccinated soon. Since complete vaccination prevents severe disease, diabetics will not need steroids, and hence will not suffer from mucormycosis.

The leopard can never change its spots — neither can the average white man his outlook towards his coloured brethren. It does not much matter even if he is an Englishman or American, two of the foremost nationalities priding themselves in their inborn love of Liberty. The colour obsession persists. National freedom and self-determination when applied to white races and European nationalities are inviolable principles of an exalted system of political philosophy based upon divine birth-right and natural justice. But the same principles, in the case of subject nations and non-white races becomes merely matters of empty sentiment or mental aberration. National honour and self-respect have, according to him, no abiding political value and significance for coloured peoples, who have merely to content themselves with the phenomena of Peace and Plenty — the one unnatural, because enforced and the other fictitious because existing only in the works of Western economists.

New Delhi, May 23: The Prime Minister, Mrs. Indira Gandhi, is believed to be reconsidering the decision taken already that members of Parliament should use Hindi expressions to denote the names of Ministries and Government departments as circulated by a Presidential notification early this month. While it was explained by officials of the Rajya Sabha and the Lok Sabha that members were under no compulsion to use only Hindi expressions when putting questions and giving notice of call attention motions, a formal request was made to members that as far as possible they should use Hindi designations of Ministers and Hindi nomenclature of Ministries and departments. But contrary to the spirit of this request, papers circulated to members yesterday by the Parliament Secretariat have revealed that all English expressions have been completely eliminated and only Hindi expressions have been used to denote the designations of ministers and ministries. The normal practice all along has been to print members’ questions both in English and in Hindi separately. Mr. Era Sezhian, D.M.K. member of Parliament, has made a strong representation to the Prime Minister and the Speaker of the Lok Sabha protesting against this “imposition of Hindi” on members to the exclusion of English.